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LABORATORY EXAMINATIONS in DIABETES

MELLITUS

1.DEFINITION:

Diabetes mellitus (DM) is a chronic disease that characterized by chanes in the

metabolism o! each o! the ma"or body !uels# source o! enery (carbohydrate$ !at

and %rotein) and is associated by disturbances o! a &ariety o! hormones.

'.*++IFI*TION o! DM

'a. DM ty%e 1 (T1DM): *utoimmune %rocess that selecti&ely destroys

%ancreatic beta cells, T cell mediated %rocess$ -ith unno-n antienic

stimuli  lac o! insulin

'b. DM ty%e ' (T'DM): carbohydrate intolerance as cardinal !eature

Insulin resistance or insulin de/ceny althouh sometimes

hy%erinsulinism can be !ound , 02 o! DM case

'c.3estational DM: DM in %renancy

'd. Other s%eci/c ty%e o! DM: dru or chemical4induced !orms o! diabetes

5.INI* +I3N+ 6 +7M8TOM+:

8olyuria$ nocturia$ %olydi%sia$ %oly%haia$!atiue$ -eiht chanes$

blurred&ision$ e9tremity %ain$ se9ual dys!untcion$ ne%hro%athy$ neuro%athy$ !oot

ulceration (anrene diabetic !oot)$ "oint %roblem

.DI*3NO+I+ o! DM

a.+creenin

+creenin !or T1DM is not recommended,

+creenin !or T'DM : checin F;3 bein at ae $ es%ecially in %eo%le

-ith ;MI

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b.Early detection o! com%lications:

serum creatinine$ microalbuminuria (microalbumin#creatinine ratio)$ E3

c.+el! monitorin blood lucose (+M;3) at least times#day:

.INTEGFEGIN3 F*TOG+:

Falsely high : de9trose IH4in!usion$ steroids$ stress$ in!ection$ caeine$

nicotine$ 4blocers$ adrenal land in!ection$ total %arenteral nutrition

(T8N)$ diuretics$ estroen$ %henytoin

Falsely low : insulin$ alcohol$ anabolic steroids$ O*D

@.+8EIFI ONDITION+:a.Diabetic etoacidosis

b.oma hy%erlycemia: hy%erosmolar

c.oma hy%erlycemia$ etoacidosis

d.oma hy%olycemia

 

HbA1 HbA1!"o"al

3ood DM control '$4$B2 J @$2

Fair DM control $14?$B2 @$40$B2

8oor DM control > ?2 > 02